title: Hospital level analysis to improve patient flow.
abstract: The complexity of hospital operations ensures that one-size-fits-all solutions seldom work. As hospitals turn to evidence based strategies to redesign flow, it is critical that they tailor the strategies to suit their individual service. This paper analyses the effect of hospital occupancy on inpatient and emergency department patient flow parameters at the Caboolture hospital in Queensland, Australia, and identifies critical levels, or choke points, that result in performance decline. The effect of weekdays and weekends on patient flow is also investigated. We compare these findings to a previous study that has analysed patient flow across Queensland hospitals grouped by size, and discover several differences in the interaction between rising occupancy and patient flow parameters including rates of patient flow, length of stay, and access block. We also identify significantly higher choke points for Caboolture hospital as compared to other similarly sized Queensland hospitals, which suggest that patient flow here can be redesigned to operate at higher levels of occupancy without degrading flow performance. The findings support arguments for hospitals to analyse patient flow at a service level to deliver optimum service improvement.
authors.affiliation: The CSIRO Australian e-Health Research Centre, Brisbane, Australia.
authors.forename: Sankalp
authors.initials: S
authors.lastname: Khanna
authors.forename: Justin
authors.initials: J
authors.lastname: Boyle
authors.forename: Norm
authors.initials: N
authors.lastname: Good
authors.forename: Simon
authors.initials: S
authors.lastname: Bugden
authors.forename: Mark
authors.initials: M
authors.lastname: Scott
mesh_terms: D003441:Crowding; D017598:Efficiency, Organizational; D005260:Female; D006297:Health Services Accessibility; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D011793:Queensland; D013997:Time Factors